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Pediatric Psychosocial Issues: Behavioral Sleep Disorders

Sleep problems are common in children and can impact all aspects of a child's functioning. Some problems are a result of the interactions between behavior, environment, and psychosocial issues. Common behavioral sleep problems include:

Bedtime fears

Bedtime resistance/refusal

Difficulty falling asleep (e.g. taking a long time to fall asleep or can't fall asleep alone)

Difficulty waking in the morning

Insufficient sleep

Night wakings (frequent and/or prolonged)

Poor sleep habits

Sleep-related head banging, body rocking, or body rolling

Sleep schedule issues

Sleep terrors

Sleep walking

Undesired co-sleeping or bed-sharing

There are also primary sleep disorders (e.g., obstructive sleep apnea) that can lead to daytime behavioral problems. Sleep problems and/or sleep disorders may result in daytime sleepiness, behavior problems (e.g., hyperactivity, inattention) or irritability. It is important for children to not only have good quality sleep, but to get enough sleep every night. Healthy sleep habits can help children with both sleep quantity and sleep quality.

Recommended Sleep For Children

A child’s sleeping habits and number of hours needed for sleep each night can vary depending on where the child is at in the stages of development. Some general pediatric sleep guidelines for amount of sleep needed for children by age range include the following:

0 to 3 months of age need 14 to 17 hours

4 to 11 months of age need 12 to 15 hours

1 to 2 years of age need 11 to 14 hours

3 to 5 years of age need 10 to 13 hours

6 to 13 years of age need 9 to 11 hours

14 to 17 years of age need 8 to 10 hours

18 to 25 years of age need 7 to 9 hours

Effects of Sleep on Development

Sleep impacts every aspect of child development, including learning, processing and remembering information. Lack of sleep can also prevent a child from paying attention in school or focusing on learning. Further, a child’s mood and behavior are affected by a lack of sleep.

Other aspects of development impacted by insufficient sleep include growth (i.e., growth hormone is released during sleep for young children), obesity (insufficient sleep causes weight gain) and health. In particular, a child’s immune system can weaken without enough sleep. A weakened immunes system can affect a child’s ability to fight off a cold and stay healthy.

Effects of Sleep on Parents

Often times when a child is not getting enough sleep, the parents are not either. When a child cannot fall asleep or wakes up early, one or both parents are often awake with the child. Lack of sleep for parents can affect their own daytime functioning, including parent mood, performance at work, ability to manage the child’s behavior and ability to drive.

Tension can occur within the family if parents do not agree on a sleeping schedule, or disagree on how to manage a sleeping problem. Family conflict can also have an effect on a child’s sleeping habits.

How Do You Know if Your Child is Getting Enough Sleep?

There are some simple ways to tell if your child is not getting enough sleep at night:

Your child is extremely difficult to wake in the morning. Children who get enough quality sleep should wake easily in the morning, and should be out of bed within 15 minutes.

If your child is sleeping two or more hours on weekends/vacations than on school nights, he/she is trying to catch up on lost sleep during the week.

If you child falls asleep in school or other inappropriate times he/she is not getting enough sleep or quality sleep.

There are noticeable changes to your child’s behavior or mood following nights of increased sleep.